超声引导下经皮滑膜射频消融术在兔AIA模型中的短期疗效观察  

Observation on Short-term Efficacy of Ultrasound-guided Percutaneous Radiofrequency Ablation of Synovial Membrane in Rabbit AIA Model

作　　者：徐琦 朱张茜 刘泽政 朱建碧 刘灵川 丁欢欢 郑洁 金纯纯 Xu Qi;Zhu Zhangqian;Liu Zezheng(Department of Ultrasound,Wenzhou People′s Hospital,Zhejiang 325000,China)

机构地区：[1]温州市人民医院超声科,325000

出　　处：《医学研究杂志》2021年第2期126-130,148,共6页Journal of Medical Research

基　　金：浙江省温州市科技计划项目(Y20170827)。

摘　　要：目的应用超声引导下经皮射频消融(RFA)术治疗AIA模型兔膝关节滑膜增生,并观察了该术式的短期疗效。方法将40只日本大耳白兔分为RFA组、非RFA组、对照组,达到成模标准后对RFA组进行超声引导下RFA术治疗膝关节滑膜增生。术后测量兔膝关节径、超声评价滑膜最大厚度、滑膜炎评分,术后第2周末处死白兔并解剖观察膝关节结构,测定髌下脂肪垫TNF-α、VEGF mRNA水平。结果 RFA组15只兔滑膜消融均成功,术后14天兔体重平稳,膝关节周径在术后第3天达到峰值,随后下降,与其他两组比较在术后第3、7天比较差异有统计学意义(P均<0.01)。术后滑膜厚度逐步减低,在术后第7天开始差异有统计学意义(P均<0.01)。滑膜炎评分在术后即刻下降,并在第2周末时未出现复发。RFA组术后第14天关节TNF-α、VEGF表达水平低于非RFA组(P均<0.05),而高于对照组(P均<0.05)。结论超声引导下膝关节RFA术有望成为治疗关节滑膜增生的微创治疗手段,在AIA模型动物实验中短期治疗效果良好。Objective To observe the short-term effect of this procedure,Ultrasound-guided percutaneous radiofrequency ablation(RFA)for the treatment of synovial hyperplasia in the knee joint of rabbits with AIA model.Methods Forty Japanese white rabbits were divided into RFA group,non-RFA group,and control group.After reaching the standard,RFA group was treated with ultrasound-guided RFA for synovial hyperplasia of knee joint.At the end of the second week,the rabbits were killed and the structure of the knee joint was observed.The mRNA levels of TNFαand VEGF in the infrapatellar fat pad were measured.Results In RFA group,15 rabbits were ablated successfully,and the weight of rabbits was stable 14 days after operation.The circumference of knee joint reached the peak on the 3rd day after operation,and then decreased.Compared with the other two groups,the difference was statistically significant on the 3rd and 7th day after operation(all P<0.01).The synovitis thickness decreased gradually after operation,and the difference was significant at the beginning of the 7th day(P<0.01),and the synovitis score decreased immediately after operation,and there was no recurrence at the end of the second week.The expression of TNFαand VEGF in the 14 days after RFA was lower than that in the non RFA group(P<0.05),but higher than that in the control group(P<0.05).Conclusion Ultrasound-guided knee joint RFA surgery is expected to be a minimally invasive treatment method for the treatment of synovial hyperplasia,and has a good short-term treatment effect in AIA model animal experiments.

关 键 词：经皮射频消融术 AIA模型 滑膜增生 动物实验研究 

分 类 号：R4[医药卫生—临床医学]